1.Evolving Cancer Classification in the Era of Personalized Medicine: A Primer for Radiologists.
Ailbhe C O'NEILL ; Jyothi P JAGANNATHAN ; Nikhil H RAMAIYA
Korean Journal of Radiology 2017;18(1):6-17
Traditionally tumors were classified based on anatomic location but now specific genetic mutations in cancers are leading to treatment of tumors with molecular targeted therapies. This has led to a paradigm shift in the classification and treatment of cancer. Tumors treated with molecular targeted therapies often show morphological changes rather than change in size and are associated with class specific and drug specific toxicities, different from those encountered with conventional chemotherapeutic agents. It is important for the radiologists to be familiar with the new cancer classification and the various treatment strategies employed, in order to effectively communicate and participate in the multi-disciplinary care. In this paper we will focus on lung cancer as a prototype of the new molecular classification.
Adenocarcinoma
;
Classification*
;
Humans
;
Lung Neoplasms
;
Molecular Targeted Therapy
;
Precision Medicine*
2.Current Concepts in Non-Gastrointestinal Stromal Tumor Soft Tissue Sarcomas: A Primer for Radiologists.
Akshay D BAHETI ; Jyothi P JAGANNATHAN ; Ailbhe O'NEILL ; Harika TIRUMANI ; Sree Harsha TIRUMANI
Korean Journal of Radiology 2017;18(1):94-106
Non-gastrointestinal stromal tumor (GIST) soft tissue sarcomas (STSs) are a heterogeneous group of neoplasms whose classification and management continues to evolve with better understanding of their biologic behavior. The 2013 World Health Organization (WHO) has revised their classification based on new immunohistochemical and cytogenetic data. In this article, we will provide a brief overview of the revised WHO classification of soft tissue tumors, discuss in detail the radiology and management of the two most common adult non-GIST STS, namely liposarcoma and leiomyosarcoma, and review some of the emerging histology-driven targeted therapies in non-GIST STS, focusing on the role of the radiologist.
Adult
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Classification
;
Cytogenetics
;
Humans
;
Leiomyosarcoma
;
Liposarcoma
;
Sarcoma*
;
World Health Organization
3.Update on Gastrointestinal Stromal Tumors for Radiologists.
Sree Harsha TIRUMANI ; Akshay D BAHETI ; Harika TIRUMANI ; Ailbhe O'NEILL ; Jyothi P JAGANNATHAN
Korean Journal of Radiology 2017;18(1):84-93
The management of gastrointestinal stromal tumors (GISTs) has evolved significantly in the last two decades due to better understanding of their biologic behavior as well as development of molecular targeted therapies. GISTs with exon 11 mutation respond to imatinib whereas GISTs with exon 9 or succinate dehydrogenase subunit mutations do not. Risk stratification models have enabled stratifying GISTs according to risk of recurrence and choosing patients who may benefit from adjuvant therapy. Assessing response to targeted therapies in GIST using conventional response criteria has several potential pitfalls leading to search for alternate response criteria based on changes in tumor attenuation, volume, metabolic and functional parameters. Surveillance of patients with GIST in the adjuvant setting is important for timely detection of recurrences.
Exons
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Gastrointestinal Stromal Tumors*
;
Humans
;
Imatinib Mesylate
;
Molecular Targeted Therapy
;
Recurrence
;
Succinate Dehydrogenase